Need help with Tricare and homebirth - Page 3

[NamastePlatypus]

Thank you that is what I thought DH told me otherwise!

DON"T GO YET TO THE HOSP!!! See my PM!!!!

[NamastePlatypus]

oh and that was me talking about her in the other forum!, LOVE her!

[StacyL]

Originally Posted by VeganPregnancy

StacyL,
I've read many of your older posts re: homebirth and tricare and I think I've got it down now!
You are the tricare/homebirth MDC goddess! I bow to you!! :

Hee hee - thank you, but I owe my initial knowledge to another MDC mama (wombat) who helped me out in the beginning of my journey with Tricare and HB, and then I spread my knowledge here after having gone through it to help others. It can be really frustrating without some help!

[VeganPregnancy]

That was you? At midwifery today? LOL I tried emailing the lady who requested the info on that forum to see what she did. But she is due this weekend and probably a little busy!! LOL

OKay wait.... I read your PM, but are you saying don't go to my appt and just wait until 20 weeks and they'll send me to a German hospital?? It'll be my first appt at Landstuhl, but I am already 'in the system' since I went to an 'educational appt' at Baumholder (which is basically where they give you a paper saying you're pregnant, for housing, even though I didn't do an labs or pee anywhere LOL)
So... you think don't go to the Landstuhl appt? Or am I already in the damn system? grrr

[NamastePlatypus]

Originally Posted by VeganPregnancy

That was you? At midwifery today? LOL I tried emailing the lady who requested the info on that forum to see what she did. But she is due this weekend and probably a little busy!! LOL

OKay wait.... I read your PM, but are you saying don't go to my appt and just wait until 20 weeks and they'll send me to a German hospital?? It'll be my first appt at Landstuhl, but I am already 'in the system' since I went to an 'educational appt' at Baumholder (which is basically where they give you a paper saying you're pregnant, for housing, even though I didn't do an labs or pee anywhere LOL)
So... you think don't go to the Landstuhl appt? Or am I already in the damn system? grrr

ohhh the being in the system might mess that up. Damn.
No that wasn't me at MWT, I thought you meant here. Yeah, she is that good! Damn the System!!!!
PMed you back

[HappyFox05]

Maybe a little off topic...

Does anyone know about homebirthing or using a birth center if the service member is the pregnant one? Actually, we're both service members, but as far as I know, he's not pregnant. I don't know if the rules for us are the same as the rules for family members. The post we're PCSing to doesn't have a major MTF - just a clinic - so everything would be done off post anyway.

Thanks!
Bonnie
Due in Dec, still can't believe it.

[NamastePlatypus]

Originally Posted by toolongatforthood

Does anyone know about homebirthing or using a birth center if the service member is the pregnant one? Actually, we're both service members, but as far as I know, he's not pregnant. I don't know if the rules for us are the same as the rules for family members. The post we're PCSing to doesn't have a major MTF - just a clinic - so everything would be done off post anyway.

Thanks!
Bonnie
Due in Dec, still can't believe it.

I think it would be the same for an AD as dependant. Are you goin to be in GA because it is allegal there they won't cover it at all from what I understand.

[StacyL]

Originally Posted by toolongatforthood

Does anyone know about homebirthing or using a birth center if the service member is the pregnant one? Actually, we're both service members, but as far as I know, he's not pregnant. I don't know if the rules for us are the same as the rules for family members. The post we're PCSing to doesn't have a major MTF - just a clinic - so everything would be done off post anyway.

Thanks!
Bonnie
Due in Dec, still can't believe it.

The good news is since you are Prime Remote due to being far from your base you don't even have to switch to Standard to get it covered. As far as I know the rules of coverage would be the same. Check that chart linked upthread (post #8) from Tricare website. You have to scroll down a ways.

Active Duty Members

If you're an active duty service member you must receive maternity services at your local MTF. If your local MTF doesn’t provide obstetric services, your primary care physician may refer you to a civilian provider. As an active duty member, you don't have any cost shares or deductibles for maternity care.

If you're enrolled in TRICARE Prime Remote, you may deliver at a local civilian hospital that your regional contractor approves.

[Shelsi]

Originally Posted by toolongatforthood

Does anyone know about homebirthing or using a birth center if the service member is the pregnant one? Actually, we're both service members, but as far as I know, he's not pregnant. I don't know if the rules for us are the same as the rules for family members. The post we're PCSing to doesn't have a major MTF - just a clinic - so everything would be done off post anyway.

Thanks!
Bonnie
Due in Dec, still can't believe it.

I was active duty when I had my ds and we only had a clinic as well so everyone was sent off base anyways. The thing is, since your're AD, you can't go to standard you have to be on Prime (or at least that's what they told me 3 years ago). So if you want a hb you need to find someone who is in network or willing to jump through the hoops to become in network which may be near impossible (esp since for many it's near impossible to find any CNMs who do hb's). We have a birth center here and the mw's there are in network, as is the actual birth center, so it's completely covered on prime.

What I would do is go to the tricare website, find your region, and then follow the "find a provider" links. Look under "midwife," see what comes up and take it from there.

As far as just paying out of pocket and doing it under the table...not sure what your command would think of that if they found out. I think if I were still active duty and couldn't find an in-network hb mw, I would just see my OB, pretend I was going to deliver with him, and just pay out of pocket for my hb midwife and then later I could just say "whoops, I didn't make it in time!" But that might be a career risk if you get found out especially if you're in an illegal state. What state are you moving to?

Just remember that if you do it all under the table and something does goes wrong and your command finds out you might be charged with damaging government property (same as if you get yourself in a fight and get hurt or get severely sunburned)

[Shelsi]

Originally Posted by StacyL

The good news is since you are Prime Remote due to being far from your base you don't even have to switch to Standard to get it covered. As far as I know the rules of coverage would be the same. Check that chart linked upthread (post #8) from Tricare website. You have to scroll down a ways.

She won't be Prime Remote though. They have a clinic and therefore an MTF, it's just not a hospital and therefore doesn't have all the services available like obstetrics and ER services. That's how our clinic is: no ER, no OB, no frills basically, but you still go there when you are ill or whatever and they refer you off base as needed (active duty or not).

[HappyFox05]

I don't think Fort Lee qualifies as Tricare Prime Remote but I don't know the criteria for that either, so I could be wrong. I've done a search on the Tricare website & the closest in-network CNM is about 60 miles away. So, it sounds to me like I might be able to work out something that we're happy with but that the Army will pay for. I'll let you know what happens!

The next step is to convince my Sweetie that we don't necessarily have to do this in a hospital. I'm hoping Ina May's book will help him out - he's pretty open minded.

Bonnie

[Shelsi]

Originally Posted by toolongatforthood

I don't think Fort Lee qualifies as Tricare Prime Remote but I don't know the criteria for that either, so I could be wrong. I've done a search on the Tricare website & the closest in-network CNM is about 60 miles away. So, it sounds to me like I might be able to work out something that we're happy with but that the Army will pay for. I'll let you know what happens!

The next step is to convince my Sweetie that we don't necessarily have to do this in a hospital. I'm hoping Ina May's book will help him out - he's pretty open minded.

Bonnie

Ok since there are no CNMs very close to you that are in network you have one more option (and it will prob by a fight with Tricare btw): IF you can find a hb CNM in your area then technically they have to let you see her even if she's not in-network. If they offer a service, like hb, but have no network providers to provide that service then they must send you out of network and still pay for it as if it were in-network. That one will be a fight.

[HappyFox05]

Originally Posted by Shelsi

Ok since there are no CNMs very close to you that are in network you have one more option (and it will prob by a fight with Tricare btw): IF you can find a hb CNM in your area then technically they have to let you see her even if she's not in-network. If they offer a service, like hb, but have no network providers to provide that service then they must send you out of network and still pay for it as if it were in-network. That one will be a fight.

Hmmmm, interesting! I'll have to look into that. Luckily, we still have a bit of time.

Thank you for all the helpful info!
B.

[StacyL]

Just remember to ask for a supervisor for any questions on this when talking to Tricare.

[saskiaofthewoods]

Still fighting with Tricare

Tricare really seems to be against midwives outside the hospitals. I don't see why. But I heard that most insurances here rather pay for a hospital. Why? And I think it is all still extremly expensive for mom's to be. I couldn't believe it when they told me that an insurance usually does not cover all the costs for the birth. Wow!

I am still arguing with Tricare. I tried to make a compromise and I told them I could maybe give birth in their hospital but I would want to give birth in the water or on a birthing wheel. They do not have anything like that, so I said I would bring my own pool. They said NO. And I said I would want to go home a few hours after birth. Again they said NO. And then they made a mistake and that guy there made me mad. I said he could not lock me in and if I would want to go home I would do that. You know what he answered? Well, then you sign the papers and you go home. But the baby stays here.
Now why would you say something like that? He said if I would sign the papers and take the baby home,too,Tricare would not cover the birth anymore and I would have to pay for it. I do not believe it. I still think they wanted to scare me. Why should they pay for everything, including me and the baby staying there for two days after, but if I do not stay, they would not pay? It would save them money....
And they have me so I do not trust them a bit anymore. So I told my husband I'd rather go find two jobs and work really hard so I can afford to give birth whereever I want or I just find a Doula, stay at home alone and call the hospital when it is too late and the baby is almost there anyways. Then they have to cover it.... Or of course I could fly home and give birth there. My German insurance would cover it all, no matter where in Germany I would give birth. But then again, it would not be fair towards my husband...

Any good job ideas for a pregnant woman?

[HappyFox05]

Hi Saskia. Maybe you know this already but the best way to learn the truth about these gov't organizations (and I mostly mean the military) is to find their regulations & look up the rules yourself. A lot of the time, if you do that, you'll be better informed than the people giving you answers. It's really time consuming sometimes, but it can be worth it.

Another alternative is to do what StacyL (I think, I'm not looking at the page right now) suggests and ask to talk to a supervisor.

One of the things I've learned after 18+ years in the Army is - if at first you don't like the answer you get, ask someone else.

Bonnie

[NamastePlatypus]

Originally Posted by saskiaofthewoods

Tricare really seems to be against midwives outside the hospitals. I don't see why. But I heard that most insurances here rather pay for a hospital. Why? And I think it is all still extremly expensive for mom's to be. I couldn't believe it when they told me that an insurance usually does not cover all the costs for the birth. Wow!

I am still arguing with Tricare. I tried to make a compromise and I told them I could maybe give birth in their hospital but I would want to give birth in the water or on a birthing wheel. They do not have anything like that, so I said I would bring my own pool. They said NO. And I said I would want to go home a few hours after birth. Again they said NO. And then they made a mistake and that guy there made me mad. I said he could not lock me in and if I would want to go home I would do that. You know what he answered? Well, then you sign the papers and you go home. But the baby stays here.
Now why would you say something like that? He said if I would sign the papers and take the baby home,too,Tricare would not cover the birth anymore and I would have to pay for it. I do not believe it. I still think they wanted to scare me. Why should they pay for everything, including me and the baby staying there for two days after, but if I do not stay, they would not pay? It would save them money....
And they have me so I do not trust them a bit anymore. So I told my husband I'd rather go find two jobs and work really hard so I can afford to give birth whereever I want or I just find a Doula, stay at home alone and call the hospital when it is too late and the baby is almost there anyways. Then they have to cover it.... Or of course I could fly home and give birth there. My German insurance would cover it all, no matter where in Germany I would give birth. But then again, it would not be fair towards my husband...

Any good job ideas for a pregnant woman?

Personally, after having a babe in German on the econmomy, it would be worth it to go to Germany, just me though:

[VeganPregnancy]

UPDATE: Yay!!!! I did it!!

Thanks to everyone for all your advice!! (Especially StacyL and NamastePlatypus!!!)
I just got super lucky and at my first appt. I asked the nurse (super sweetly) if there was a way to "mark a box" so that I could somehow end up at a German hospital (for my "home away from home" birth) and she was able to defer me to one!!!!
So, I do all my prenatal care there and deliver there unless I become a "complicated case" LOL, whatever!
I'm still on Prime and everything! I just got super lucky! WHEW!
She even told me "not to tell anyone" that she deferred me.
This is a HUGE relief to me and DH!

[CEG]

Originally Posted by toolongatforthood

Does anyone know about homebirthing or using a birth center if the service member is the pregnant one? Actually, we're both service members, but as far as I know, he's not pregnant. I don't know if the rules for us are the same as the rules for family members. The post we're PCSing to doesn't have a major MTF - just a clinic - so everything would be done off post anyway.

Thanks!
Bonnie
Due in Dec, still can't believe it.

Unfortunately active duty members do not have options like family members do. I had both of my kids while on active duty and no luck. The post I was at had a clinic and no MTF, so all pregnant soldiers saw the OB clinic on post and gave birth in the local civilian hospital with the military providers. I was lucky enough to find a great military CNM who was willing to come in when I was in labor (vs. the on call provider). Otherwise I have to say I don't think the experience would have been good.

Another thing no one will tell you is that when an Active duty mother gives birth the baby is automatically registered in DEERS and Tricare prime under the mother. This could cause a LOT of problems if you, say, registered your newborn as a dependant under the active duty father without knowing babe was already registered under the mother.... Months and months of headaches because of a stupid policy.

Definitely start exploring all your options now. You will not be allowed to switch to standard but maybe you can get a referral to a CNM out of network. I don't know, although I wanted to I never tried. I have always found the Tricare reps on post to be very helpful and friendly so give them a shot. Best of luck to you and congratulations... Also, if you have any other questions about active duty pregnancy/ mothering I would be happy to help It can be a little intimidating sometimes.

[EmmaJean]

My experience (from friends) is it depends from mom to mom. Every situation is different, and they can agree to pay different amts to different people. It's like everyone has their own interpretation of the regs. Very confusing and frustrating to say the least. So don't let anyone tell you "don't even try"! UNLESS homebirth isn't regulated in your state (like mine). But if it is, there's a chance that you can fight your way for a homebirth that is covered in some way by tricare. Good luck!!! In some ways, I'm glad I don't even have the option to fight w/ tricare over this birth. I'm not sure if I would. But it sounds like StacyL has had some very positive experiences, and that's great!